gynecology advice (oh yeah this is staying anonymous)
May 23, 2012 5:23 PM   Subscribe

Going to the gynecologist tomorrow: What to ask/test for and should I use my insurance?

If you are a patient person, can you read over my history and suggest other questions/things to test or talk to my doctor about at my gynecology appointment tomorrow?

I am a 28 YO lady and I'm headed to the gyno for a pap smear and to check up on all my lady business. I've had 4 oral sex partners w/o protection, but I've never had penetrative intercourse. I've had 2 pap smears before, both normal, and I've had STD testing before that came up negative, but I have had 2 oral-sex partners since my last round of testing.

Since my last visit to the gyno ~2 years ago, for the last 3-4 months, I've had my first yeast infection, and general vaginal swelling/redness/soreness/more discharge than is typical for me, which started after antibiotics. I self-treated the yeast infection with OTC drugs and finally an antifungal prescription, but I still feel like there is some swelling and extra discharge. I'm going to explain these concerns and request testing for bacterial vaginosis, based on my symptoms. I am also going to request an STD panel of testing, and specifically am concerned about chlamydia due to extra discharge. After a recent askme question, I am also going to ask about what I think may be minor hemmorhoids. Is this appropriate to ask a gyno? I know they probably deal with them with post-preggers women, but I've never been pregnant.

I've also had very light bleeding in combo with a discharge between periods about 1 week-10 days after my period has ended. I think this is ovulation bleeding, and it's only happened during my last 2 periods. My periods have always been like clockwork, but in the last few months my cycle has been a big longer, with more days between periods, and an extra day or two of having my period. I'm going to share these concerns as well.

Oh! Occasionally (maybe twice a week) I'll have a sudden urge to use the restroom, but it is definitely not a problem in my life or something I would want to take medicine for. I'm open to monitoring it and doing kegels, that type of thing.

Other than being open and honest with my history and answering all my doctor's questions, are there any other things that I should use this appointment for specifically? (If you've made it this far, thank you, I just don't want to overlook something given my many but mild/moderate symptoms.)

Finally, I am covered by my work insurance, but I don't particularly like my job and may want to switch/be self-covered within a couple of years. Should I request that my insurance NOT be billed for the STD testing? Is it typically possible for doctor offices to be able to bill insurance for the checkup/pap smear, but NOT for the STD labwork? (I know I will learn from my particular doctor, but I am interested in others' experiences.)

Sincere thanks for tips/thoughts/advice.
posted by anonymous to Health & Fitness (4 answers total) 1 user marked this as a favorite
All of your symptoms sound like things that you should bring up with your doctor. Maybe it's BV, maybe it's a pelvic infection, maybe it's a UTI, you don't know without thorough investigation. Share all potentially medically relevant information. It will help them diagnose and might prevent serious problems. You can ask about anything, really.

Re: insurance, why wouldn't you have them bill the tests? That's what health insurance is for. The fact that you don't like your job is irrelevant, under HIPAA regulations they can't share the details of your treatment with your employer anyways (see for more on patient protection and privacy). Some of these tests may be fully covered and some might not, but that is the point of having insurance.

Also, since you are concerned, you might want to start using dental dams, which might help you worry less.
posted by epanalepsis at 6:11 PM on May 23, 2012 [1 favorite]

Are you worried about having a diagnosis on your insurance? Generally, if you get a diagnosis while covered by insurance, you're okay. It's just dangerous to get a diagnosis while not covered by insurance because future insurance policies probably won't cover it. But you should be fine here. I am not your insurance specialist. It would be a good idea to talk to whoever administers the health plan at your job about pre-existing conditions and such. You don't have to be specific about STDs or anything.
posted by bleep at 6:38 PM on May 23, 2012

You can ask your gynecologist if you have external hemorrhoids because he or she will be looking at your anus during the exam and will be able to easily tell you. Gynecologists don't perform any surgical treatments for hemorrhoids, but if they are not bothering you with pain or bleeding then there is nothing you need to do for them aside from eat more fiber or use stool softeners if you have constipation.

Aside from the things you've mentioned, the only other things I can think of to ask about would be any preventative shots you need to avoid a second primary care visit (like flu or tetanus updates, although it's not really flu season around here anymore), or asking about contraceptives if you were interested in them (could regularize your periods and stop the spotting).

I would prioritize talking about the increased discharge issue and the spotting, and if you don't have time in the appointment to address the occasional bladder urgency issue, it doesn't sound like there is much to discuss on that front since it's not bothering you and you already know about Kegels. (You could also cut out caffeine if you haven't already)
posted by treehorn+bunny at 9:34 PM on May 23, 2012

i just came in here to say - don't forget to request some sort of breast exam when you're there. most every time i've been to the ob/gyn, the doctor has performed one, but i'm not sure if it's an absolute.

(i don't think it's related at all to your symptoms, but something young women (and all women) should be mindful about.)
posted by alice ayres at 4:41 AM on May 24, 2012

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